Core--Forecasts and Changes in Health and Illness Costs

核心——健康和疾病成本的预测和变化

• 批准号: 6664382
• 负责人: P.J. ERIC STALLARD
• 金额: $ 14.57万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-09-30 至 2003-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6664382
• 关键词: Medicare /Medicaid; behavioral /social science research tag; biomedical facility; computer simulation; health care cost /financing; human data; human old age (65+); model design /development; prognosis

This core will support the production of computer based forecasts and simulations of changes in the health and functioning of the U.S. elderly population and estimate the cost differentials associated with changes in those forecasts due to the use of different assumptions. The empirical basis of these forecasts will initially be the changes in functional status and dimensions and mortality assessed in the 1982, 1984, 1989, 1994, and 1999 NLTCS. The model is designed so that the parameters of the health process can be made functions of different types of non-health inputs generated by modeling effects in various of the specific research projects. Thus, models of economic effects on health will be generated in Projects 2, 3 and 4. Project 1 will deal with the methodological issues involved in constructing the mathematical interfaces of the health forecasting model with the other models developed, and empirically calibrated, in the various projects. One of the major issues to be dealt with in the sub-projects is how research investment relates to the rate of adoption, and efficacy of, clinical innovations. There is relatively little direct data on this relation, That is, it is possible to derive estimates of the amount spent on specific types of research, to derive estimates of the amount spent on purchasing specific clinical services made possible by that research, and to derive estimates of how much health is changed by various levels of health spending. There is little data directly relating research investments to changes in health for specific individuals however. Thus, we propose to use the available data and link in a mathematically consistent structure with inputs from experts on biomedical research and from experts on the clinical application of specific technologies. We will examine the sensitivity of health outcomes to such investments taking account of the evident degree of stochastic and construct uncertainty. That effort will help in identifying types and sources of additional evidence that may help to resolve some of this uncertainty.

该核心将支持对美国老年人口健康和功能变化进行基于计算机的预测和模拟，并估计由于使用不同假设而与这些预测变化相关的成本差异。这些预测的实证基础最初将是 1982 年、1984 年、1989 年、1994 年和 1999 年 NLTCS 中评估的功能状态和维度以及死亡率的变化。该模型的设计使得健康过程的参数可以成为不同类型的非健康输入的函数，这些非健康输入是通过对各种特定研究项目的效果进行建模而生成的。因此，项目 2、3 和 4 将生成对健康的经济影响模型。项目 1 将处理构建健康预测模型与各个项目中开发的其他模型的数学接口所涉及的方法论问题，并根据经验进行校准。子项目要解决的主要问题之一是研究投资如何与临床创新的采用率和功效相关。关于这种关系的直接数据相对较少，也就是说，可以得出对特定类型研究的支出金额的估计，得出对购买该研究可能实现的特定临床服务的支出金额的估计，以及得出对不同水平的卫生支出改变健康程度的估计。然而，几乎没有数据直接将研究投资与特定个人的健康变化联系起来。因此，我们建议使用现有数据，并以数学上一致的结构与生物医学研究专家和特定技术临床应用专家的输入进行链接。我们将考虑明显的随机性和构造不确定性，研究健康结果对此类投资的敏感性。这项工作将有助于确定可能有助于解决部分不确定性的额外证据的类型和来源。